SlideShare a Scribd company logo
Charge capture
EOB processing
Coding
Claim submission


Patient collections


Insurance follow up


Registration


Customizable
Healthcare Workflow
Management
Automation
What is Automated
Workflow?
Automation in
workflow
Why is workflow management essential in the
RCM process?
Why can’t each department of RCM function
separately without any communication?
What is the role of automation in workflow
management?
We ask ourselves these questions every time when the
whole RCM process is on the verge of collapsing.
Worry not fellow Healthcare management and
administrative C suitors. BillingParadise provides a
hybrid workflow management with automation.
A good definition of workflow is a logical sequence of
operations which are carried out in order to obtain
a pre-defined result
Here’s an example of how a customizable healthcare
workflow RPA should function:
Robotic Process Automation (RPA) is emerging as one
of the most transformational technologies that
can help healthcare providers by automating many of
their labor intensive, costly, and error prone tasks.
IPA has the potential to free up resources from
mundane administrative tasks and unlock data that is
buried in fragmented applications. Utilizing RPA in
RCM also helps healthcare providers maintain
compliance and increase collections rates. This, in
turn, accelerates their cash flow, reduces their
accounts receivables, and minimizes write-offs.
Simple process automation are becoming more
mainstream for simple, rule-based, repeatable
processes. But more complex processes, such as RCM,
require smarter tools which can understand the
complexities and high level of variation that is found
in the end-to-end process of getting paid. RPA is
currently being applied to processes like:
Applying RPA enables healthcare providers to realize
additional revenues, capture information for claims
disputes, and gain insights into the efficiency and
effectiveness of their revenue cycle. RPA has amazing
potential to make revenue cycle management a
strategic strength versus a cost and administrative
burden.
01
03
07
05
09
Rendering medical services into
billable charges.
Properly coding diagnoses and
procedures.
Applying or rejecting payments
through remittance processing.
Collecting pre registration information,
such as insurance coverage, before a
patient arrives for inpatient or outpatient
procedures.
Examining the necessity of medical
services
Submitting claims of billable fees to
insurance companies
Determining patient balances and
collecting payments.
Collecting payments from third-
party insurers.
Collecting subsequent patient information
during registration to establish a medical
record number and meet various
regulatory, financial and clinical
requirements.
02
04
08
06
Preregistration
Utilization review
Out of Pocket Estimation
Patient communication
Prior Authorizations
Process claim denials
inquiries@billingparadise.com
+1 888-571-9069 billingparadise.com

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Customizable Healthcare workflow management automation.pdf

  • 1. Charge capture EOB processing Coding Claim submission Patient collections Insurance follow up Registration Customizable Healthcare Workflow Management Automation What is Automated Workflow? Automation in workflow Why is workflow management essential in the RCM process? Why can’t each department of RCM function separately without any communication? What is the role of automation in workflow management? We ask ourselves these questions every time when the whole RCM process is on the verge of collapsing. Worry not fellow Healthcare management and administrative C suitors. BillingParadise provides a hybrid workflow management with automation. A good definition of workflow is a logical sequence of operations which are carried out in order to obtain a pre-defined result Here’s an example of how a customizable healthcare workflow RPA should function: Robotic Process Automation (RPA) is emerging as one of the most transformational technologies that can help healthcare providers by automating many of their labor intensive, costly, and error prone tasks. IPA has the potential to free up resources from mundane administrative tasks and unlock data that is buried in fragmented applications. Utilizing RPA in RCM also helps healthcare providers maintain compliance and increase collections rates. This, in turn, accelerates their cash flow, reduces their accounts receivables, and minimizes write-offs. Simple process automation are becoming more mainstream for simple, rule-based, repeatable processes. But more complex processes, such as RCM, require smarter tools which can understand the complexities and high level of variation that is found in the end-to-end process of getting paid. RPA is currently being applied to processes like: Applying RPA enables healthcare providers to realize additional revenues, capture information for claims disputes, and gain insights into the efficiency and effectiveness of their revenue cycle. RPA has amazing potential to make revenue cycle management a strategic strength versus a cost and administrative burden. 01 03 07 05 09 Rendering medical services into billable charges. Properly coding diagnoses and procedures. Applying or rejecting payments through remittance processing. Collecting pre registration information, such as insurance coverage, before a patient arrives for inpatient or outpatient procedures. Examining the necessity of medical services Submitting claims of billable fees to insurance companies Determining patient balances and collecting payments. Collecting payments from third- party insurers. Collecting subsequent patient information during registration to establish a medical record number and meet various regulatory, financial and clinical requirements. 02 04 08 06 Preregistration Utilization review Out of Pocket Estimation Patient communication Prior Authorizations Process claim denials inquiries@billingparadise.com +1 888-571-9069 billingparadise.com